Syphilis Cases in the City Rise By 55%, Health Officials Say

By NICHOLE M. CHRISTIAN

Published: January 31, 2003

The number of syphilis cases in New York City rose by 55 percent last year from 2001, with the increase primarily among gay and bisexual men, health department officials said yesterday.

It was the second consecutive year that the number of syphilis cases in the city rose sharply. Health officials said the increases were a troubling sign that some segments of the population were ignoring warnings to practice safe sex.

Dr. Thomas R. Frieden, the city's health commissioner, said preliminary figures from a recent survey showed 436 new cases of the disease in 2002, compared with 282 cases in 2001. That year's figure was about a 140 percent increase from 2000, when 117 syphilis cases were reported.

Dr. Frieden said the number of new cases, while small, underscores the alarming rate at which syphilis is resurfacing on the streets of New York. Recent studies have shown steady increases in syphilis cases in cities like Los Angeles, Miami and Houston, he said. ''This is a very troubling multicity outbreak that is almost exclusive among men who have sex with men,'' he said.

In New York, the steepest increase in reported cases was among white men living in Manhattan, though African-American and Hispanic men throughout the city continue to be affected at high rates, according to the survey, Dr. Frieden said.

Perhaps most disturbing, health officials said, was that 230 of the men diagnosed as having syphilis last year were also carrying H.I.V. About 70 percent of the men in the study said they knowingly risked the health of their sexual partners.

Syphilis reached near epidemic status in New York in 1990, when 4,265 cases were reported. It spread as the use of crack cocaine increased and sex in exchange for drugs became common, health officials said. By 1998, the number of reported cases was whittled to 82, most involving men who have sex with men.

Syphilis typically begins with a sore on the hand, mouth or in the genital area. If left untreated, the symptoms will disappear but the germ will remain in the body and may seriously damage the brain, the heart and the nervous system.

Aaron Glatt, head of infectious diseases for St. Vincent Catholic Medical Centers said the increase in syphilis cases needed to be monitored carefully. ''The numbers are still relatively small compared with other major health issues like AIDS,'' he said. ''But it's extremely disconcerting that the cases are continuing to go up and not down.''

Gay organizations were troubled by the study. ''It shows the magnitude of the challenge of promoting safe sex and the message of prevention,'' said Ronald Johnson, associate executive director of the Gay Men's Health Crisis. Two years ago, the group added syphilis testing to its H.I.V. testing services.

''We know that the H.I.V. safer sex message worked in the late 80's and 90's,'' he said, ''but it has to be retailored to a new generation of gay and bisexual men who are just coming into sexual maturity. They are the ones who must get the message.''

Chart: ''UPDATE: Syphilis Rates Rise'' After a steady decline of reported syphilis cases in New York City over the past decade, the number of cases has risen in each of the last two years. Graph tracks number of reported syphilis cases in New York City since 1990. 2002: 436 cases* *Preliminary (Source: New York City Department of Health and Mental Hygiene)